This invention relates to endotracheal tubes which are well known in the medical and surgical fields for their use in administering oxygen or anesthesia to a patient and for maintaining an airway to a patient's lungs. More particularly, this invention relates to devices for securing such tubes to a patient's face, monitoring the depth of insertion of the tubes and providing for easy connection and disconnection to medical and surgical devices.
Exemplary devices for securing a tube to a patient's face are disclosed in U.S. Pat. No. 4,270,529 to Muto, wherein a faceplate is held in position by strands located around the head, said faceplate including a slot for sliding a mouthpiece in position to hold the tube. U.S. Pat. No. 2,820,457 to Phillips discloses a positioning retainer which includes a rotatable body member which engages a mouthpiece for compressing a tube and holding it in position.
These known devices are not practical to use. They include many parts that have to be assembled which can take excessive time in critical situations, and they also burden the health care professional with the problem of checking all these parts and connections which distracts attention away from the problem at hand; namely, caring for a patient during an emergency or during intensive care. Moreover, in Muto, some disadvantages are associated with the faceplate. The faceplate extends around the ear in which case the edge of said faceplate could cause injury to the outside of the ear. Also the positioning and removing of the strands requires that the head of the patient be tilted forward causing discomfort to the patient, especially with the tube lodged in the throat.
A more conventional method for securing a tube to a patient's face involves wrapping tape around the outside of the tube and onto the face of the patient. This method is undesirable because the tape does not remain in place due to wetness from the patient's saliva, sweat from the skin of the patient or for other reasons. Therefore, the tube can slide up and down within the trachea of the patient. Such sliding of the tube can have critical ramifications. For example, if the tube slides too far down into the lungs, only one half of the lungs may be supplied with oxygen or anesthesia, and the other half of the lungs may collapse. If the tube is located too high up in the throat, its intended functions also cannot be achieved. The presence of the tape on the tube causes another problem, specifically, the tape covers up numbers located on the outside of insertion of the tube, said numbers indicating the depth of the tube into a patient's throat. Moreover, the numbers, even when not covered by the tape, are difficult to read from a distance because of their small size. Still further, nurses, technicians or orderlies involved with checking the depth of the tube do not always understand the meaning of the numbers and accordingly, have difficulty in determining if the tube is inserted a proper depth into the patient's throat.
A still further disadvantage associated with these and other tubes relates to attaching the tubes to medical and surgical devices. Particularly, tubes are fitted at their connection end with a universal connector. The universal connector is lodged inside the tube and is held in place by a frictional pressure exerted on its outer surface by the inside walls of the tube.
Normally, the connection end of the endotracheal tube, which engages the universal connector, has a diameter which is larger than the diameter of the remainder of the tube to permit insertion of the universal connector into the tube. A major problem arises when the connection end of the tube is cut to conform to a required length. For example, if the endotracheal tube is inserted into a patient having a trachea, such as an infant, the tube sticks out of the mouth of the patient much too far, thereby requiring the connection portion of the tube to be cut to shorten the tube. Thus, if the large diameter portion of the tube located at the connection portion of the tube is removed by cutting, a much larger force will be required to insert the universal connector into the smaller diameter portion of the tube. Particularly, the tube will have to be stretched in a radial direction to accommodate the universal connector. Consequently, it is even more difficult to insert and dislodge the connector because of the stronger frictional pressure exerted on the connector by the inside portion of the endotracheal tube walls. The additional force required to insert and dislodge the universal connector is undesirable because such force can result in accidentally pushing the tube too far into the treachea of the patient or pulling the tube too far out of the trachea of the patient.